I have a patient who has had an almost total knee reconstruction (only patella ligament left) about 9 months ago, who suffers from inflexibility and weakness of the knee.

She has consistently done the exercises prescribed by the surgeon, but still experiences more weakness(medial) and inflexibility than one would expect.

Previously I have used 4 knee eyes, ah shi points, Liv8 (tendons), St36 (qi), liv3 & kid 3(yin). This has brought some benefit in terms of increasing flexibility, and the problem is probably more so the low number of treatments (2 treatments spaced 4 days apart).

Any suggestions, changes? And how often do you recommend treatments?

Unfortunately, as I share my treatment space, I am unable to use moxa.

In such a case, where the problem is mainly of weakness and inflexibility, main points - actually most of the points - need to be in the vicinity of knee joint. The points are placed surrounding the area where the main symptoms are located, whether the medial or lateral aspect of the joint. Manipulation of the needles is aimed at invigorating qi and blood circulation, in order to provide a better nourishment to the muscles and ligaments of the joint. Best treatment is carried out daily, or every other day. Sometimes, you may find that the muscles and tendons around the joint are very tight, and blood circulation is impeded. In such case, it is advisable to perform also blood cupping on the spot of stasis. This is done by scratching the skin superficially with a tip of a syringe needle, and then quickly applying the cup over the scratches. You may leave the cup in situ for 10-15 minutes.

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